Health

This study was undertaken to establish the prevalence of illicit drug use among women of childbearing age in Alabama, an urban state with scattered rural areas. Subjects included 5,010 women (2,970 were pregnant) who enrolled in public health maternity and family planning clinics or in a high-risk obstetric referral clinic in Birmingham. Urine samples from these women were tested anonymously for marijuana, cocaine metabolites, opiates, amphetamines, and barbiturates. The test results were analyzed with consideration of subjects' demographic characteristics. Positive results for at least one drug were found for 646 patients (12.9 percent), with 11.3 percent testing positive for marijuana; 1.4 percent for cocaine; 0.6 percent for barbiturates; 0.4 percent for opiates; and 0.3 percent for amphetamines. Fifty-two women (12.4 percent) tested positive for two or more drugs; mostly cocaine and marijuana. Whites were twice as likely as blacks to test positive for any drug or for marijuana. Blacks were 2.1 times more likely than whites to test positive for cocaine. Single women were 2.6 times more likely than married women to test positive for cocaine. Older women (over 20 years) were more likely than younger women to test positive for any drug, marijuana, or cocaine. Eleven percent (326) of the 2,970 pregnant women were positive for one or more drugs; the rate for nonpregnant women was 15.6 percent. For cocaine, no differences were found in the rate of positive results between pregnant and nonpregnant women, but nonpregnant women were more likely to test positive for any drug and for marijuana. Twelve percent (45 women) of the 374 high-risk obstetrical patients tested positive for at least one drug. No differences in prevalence were noted between urban and rural areas. These results were obtained from a randomly selected sample of women who visited public health clinics during a two-week period. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors associated with the increasing prevalence of pneumonia during pregnancy

Article Abstract:

Pneumonia in pregnant women was associated with considerable maternal morbidity and mortality prior to the introduction of antibiotics, but its incidence has plummeted from 1 per 118 deliveries prior to 1956 to 1 per 2,288 deliveries. However, increasing rates of drug use and infection with HIV (human immunodeficiency virus) in the past five years may have increased the incidence of pneumonia in pregnant women. To learn more about this, medical records of women admitted to one medical facility before delivery were reviewed. The facility serves a large indigent population in New York City. The incidence of pneumonia, pregnancy outcomes, and exposure variables were evaluated. Twenty-six cases of pneumonia were detected in a group of 9,560 deliveries, for a rate of 1 case per 367 deliveries. Premature labor or delivery did not take place while the patients were hospitalized for pneumonia; however, birth weight was reduced for patients who had the disease as compared with a control group of women who delivered at the same hospital during the same period. No case of pneumonia occurred during the summer, and 15 cases were diagnosed between September 1988 and January 1989. The bacterial agents identified as causal are described. Patients remained in the hospital slightly more than eight days, on average, and were fever-free by the third day of antibiotic treatment. Ten patients had underlying medical conditions, and the group had a higher rate of cocaine use (52 percent) than the control group (10 percent). Three women (of 11 tested) were HIV-positive. Overall, the prevalence of pneumonia in this group was increased considerably (seven-fold) over statistics published in other studies. This increase is undoubtedly due, in part, to the increase in chronic medical conditions, cocaine addiction, and HIV infection in pregnant women. (Consumer Summary produced by Reliance Medical Information, Inc.)

Screening for substance use in pregnancy: a practical approach for the primary care physician

Article Abstract:

Primary care physicians only need to ask all pregnant women if they have ever smoked or drunk alcohol in order to identify those in need of further screening for drug or alcohol abuse. This was the conclusion of researchers who questioned 2,002 pregnant Medicaid recipients.